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Caesarean sections are the new ‘normal’ in private hospitals across India, with such deliveries accounting for 54% of births in private facilities in 2023-24. In Bengal, C-section deliveries at private facilities stood at 87.7%, while Telangana accounted for 84% and Andhra Pradesh 66%.This was revealed in data from the National Family Health Survey for 2023-24 released on Friday.In Telangana and Andhra Pradesh, over 62% and 52%, respectively, of all deliveries are through C-sections, while it was 44.5% in Bengal.Of the 27 states and the two large UTs of Delhi and J&K, in 18 states, more than half the births in private facilities are C-sections.
India’s C-section births have been steadily increasing over the years from 8.5% of births in 2004-05 to 17.2% in 2015-16 and then to 21.5% in 2019-21. In the latest report, more than a quarter of the births (27.2%) are through C-section. The increase has been slower in govt hospitals, going up from 15.2% in 2005-06 to 16.9% by 2023-24.In Jammu & Kashmir, the C-section rate is as high as 90% in private facilities and almost 49% in govt facilities. Hence, though govt facilities account for 80% of births, C-sections account for more than half the deliveries happening in the UT. In southern states, the proportion of C-sections is high even in govt hospitals with more than 39% births through C-sections in govt facilities in Tamil Nadu and Kerala, 38% in Andhra Pradesh, over 34% in Karnataka and 48% in Telangana.Though the share of C-sections in private facilities is as high as 81.4% in Assam and 76.8% in Odisha, the overall share of C-sections is relatively low because over three-fourths of deliveries take place in govt facilities where C-section rates are low – 18% in Assam and about 22% in Odisha’.While in most of India the problem is an inordinately high level of C-sections, at the other end are states like Bihar, Jharkhand and Madhya Pradesh, where the overall proportion of C-section deliveries is extremely low- about 13% in Bihar and 16% in Jharkhand and Madhya Pradesh. This is because of the abysmally low proportion of C-sections in govt facilities – 2.7% in Bihar, 6.1% in Jharkhand and over 10% in Madhya Pradesh.This would be more an indication of poor access to emergency medical procedures in govt facilities considering that the maternal mortality in these states is also high. This seems to be the case in Rajasthan too.While the WHO considers 10-15% to be the acceptable C-section rate, most countries have rates well above this. For instance, the proportion of C-section deliveries is over 32% in the US and 45% in the UK. In Brazil it is over 52%, and in Latin America it is over 42%. However, in many Scandinavian countries with a focus on reducing unnecessary surgical interventions and where pregnancies are managed by midwives, such as Sweden and Norway, the rates are 19% and 16%, respectively. In France, it is about 21%.
